I was graciously given the afternoon off of work. I cried for most of the drive home, managing at times to sing in a whisper along to the song "You Never Let Go" by Matt Redman. Aaron sweetly arranged for a caffeinated treat for me. Once I got home, I promptly tore off the estrogen patches and settled in to finish reading The Eyre Affair by Jasper Fforde.
Although I am grieving the loss of this chance for pregnancy, I feel a peace that passes understanding. Aaron and I have faith for whatever God has in store for us. Right now, I could truly say, with Job, that "though He slay me, I will hope in Him" (Job 13:15). Please pray that the Lord's grace would sustain that spirit in my heart.
We're going to take a break from infertility treatments for a little while. We have some traveling we want to do in the fall, and I'm tired of having extra hormones coursing through my body at all times. Our insurance will cover up to two more IVF attempts, so we may still use those at some point in the future. But for now, we've had enough.
That perches in the soul,
And sings the tune without the words,
And never stops at all,
And sweetest in the gale is heard;
And sore must be the storm
That could abash the little bird
That kept so many warm.
I've heard it in the chillest land,
And on the strangest sea;
Yet, never, in extremity,
It asked a crumb of me.
My little bird of hope is fluttering its wings desperately against the winds of low expectations for tomorrow's results right now. Oh, Lord, give me true hope, whatever the outcome of this IVF!
(We had the privilege of sharing this testimony about our infertility at church this morning. To hear the audio version - and a really outstanding message - see the sermon from 7.29.2007 here.)
We have been married for 4 ½ years. A little over a year into our marriage, we were eager to grow our family by having kids. However, for financial reasons, it seemed wise to wait a year before starting to try for children. Little did we know, that wait was just the beginning of a very difficult season.
We had been trying to conceive for about six months when we started to get worried. The months continued to pass, and we scheduled a visit with the doctor. At first, our doctor did not take our concerns very seriously, so we delayed testing for a few months. Then when we did have tests run, the results were read incorrectly and we were told there was no problem, when in fact there was. Finally, almost a year and a half after we began trying to have children, we got a referral to an infertility specialist. It took a few months to complete further testing, and in July 2006 we began fertility treatments. Of the various medications and procedures that we have tried, nothing has worked yet.
The suffering of infertility has squeezed us in so many ways. Scripture tells us that having children is good and God-honoring, that children are a reward, and yet our desire for children has gone unfulfilled. Unlike most sorrow that gradually subsides, our grief for the children missing from our home is renewed and heightened month after month. While we have been trying to conceive, we have watched all of our friends get pregnant and have babies, and many of them have gone on to get pregnant and even give birth again. There are unique challenges to being infertile in a very fertile church (although there is no church where we would rather be)! Our infertility treatments require frequent doctor appointments and invasive, intensive medical procedures. As husband and wife, we have experienced different reactions to infertility, and that has sometimes led to misunderstanding and conflict – however, our marriage has grown richer and stronger and closer as we endure trial together.
In the teeth of this trial, we have had to fight hard to cling to God’s sovereignty and goodness. Those truths have rarely been self-evident over the past 2 ½ years; the circumstances of infertility have seemed to veil God’s power and kindness. When we ask why we have not been allowed to conceive when it happens so easily for others, when we ask why God will not heal us or answer our pleas to have children, there are no easy answers. But as every false hope is stripped away, we find a firm hope in our Savior. When we think that conception is impossible for us, we remember that all things are possible with the One who became incarnate through a virgin birth. When we wonder if we could earn children by just praying harder or by learning some spiritual lesson, we recall that our actions will always fall short of earning us anything, but that Jesus lived a perfect life on our behalf. When we are tempted to see infertility as some sort of cosmic punishment, we rest in the truth that we are justified in Christ who once and for all turned away the wrath of God by bearing it on the cross. When we worry that the Lord has forsaken us and favored other couples, we revisit the cries of the Son forsaken by his Father so that we would never be. When we feel like no one understands the depth of our heartache, we return to
Time does not permit us to detail every way that God has grown us through this trial. We have learned so much from Scripture, from fellow believers, and from godly authors. Time also does not permit us to thank everyone who has prayed for us, encouraged us, and practically cared for us. You as a church have helped us to carry the burden of infertility over these past years. We look forward to seeing your prayers answered and to join with you in watching God’s goodness unfold.
This is my saline sonogram public service announcement. Every day, a few people stumble on to my blog using the search terms "saline sonogram." They end up at this post, which probably doesn't offer much help if you're about to have the procedure done and wondering what to expect. So here's one patient's view of the saline sonogram.
A saline sonogram, like its cousin the hysterosalpingogram (HSG), forms part of the standard infertility work-up. Judging by infertility blogs and message boards, the HSG is more commonly done. Both saline sonograms and HSGs are diagnostic tools. By filling the uterus and fallopian tubes with fluid, doctors can check for structural abnormalities or blockages. As far as I can tell, there are only two essential differences between the two: the HSG uses dye and an X-ray, while the saline sonogram uses, as its name implies, salt-water and an ultrasound.
I've had two saline sonograms - one during the diagnostic process after being referred to an RE (reproductive endocrinologist), and one done as a mock embryo transfer prior to my first IVF. My nurse recommended taking Advil an hour or so before my appointment. The doctor used a speculum, just like in a Pap smear, and then she cleaned the cervix to prepare for the catheter. I didn't find this part very uncomfortable; Pap smears don't bother me too much, either, if that's any indication for you. Then, guided by ultrasound (I think vaginal, but I honestly can't remember), the doctor threads the catheter through the cervix into the uterus. In my experience, this is uncomfortable but not painful; it feels like a pinch. After the catheter is clearly in the uterus, the saline is pumped through to fill the uterus, flood the fallopian tubes, and hopefully spill right out. This is when I felt some strong cramps. On a pain scale of 1-10, I'd put them at around a 6. They made me grit my teeth, but not gasp in anything close to agony. And then, it's done! All the foreign objects get removed from your body, the water comes gushing back out, and the saline sonogram is over. The first time I had it done, I rested at home for the rest of the day. The second time, I went straight to work afterwards.
So there you have one person's experience of the saline sonogram. I'm not a medical professional, and not all saline sonograms or patients are exactly the same, but hopefully this gives you some idea of what to expect. Good luck!
Any readers who have had a saline sonogram? Feel free to add extra details or your own experience in the comments.
While I'm on the topic of things that I do not like today, let's talk about estrogen patches. My current opinion: they just might be the worst part of this whole IVF process. The shots, sure they hurt, but they are over and done with quickly. The patches? Slow torture. The large, shiny things stick and un-stick in the most ungainly way. The two that I applied last night to my stomach crinkle and buckle every time I move. They have started to peel off, and I'm still supposed to wear these two for about 28 more hours before I exchange them for new ones. I've applied butterfly bandages (the best adhesive I had on hand; note to self: buy surgical tape at Target) to their edges, and now five different sticky things are sliding around my skin and adhering to each other instead. Maybe I can find a better place to apply them, but for now they have been bothering me all day long. They even bother my unconscious! Last night, I dreamt that I had some sort of heart attack due to too many hormones coursing through my body. Some medical person told my recovering, breathless, heart-racing self that it was because I had worn two estrogen patches instead of one. "Nurse Answers told me to wear two!" I protested, only to discover that I had a new version of the patch, one that was twice the size and twice the dose of the ones that the fertility clinic had used before. So I had, in fact, overdosed on estrogen patches based on outdated instructions. That was my dream, played out in my sleeping mind within the first seven hours of wearing these silly patches. They are not my favorite.
Of course, all the book-less boredom and pestering patches will be worth it if this blastocyst takes hold and gives us good news in a week...
*By the way, what do you all think of the new font size? Before my transition to working at home, I worked on a behemoth of a desktop that had a monitor with very low resolution, so I only recently realized that I might have been making you all very squint-eyed with my type. Apologies if that was the case!
After breakfast, we headed into the city. We had to wait for a while at the clinic, and then we had to wait some more in the room where the transfer would be done. Finally, the doctor came to tell us the status of our embryos. Of the four that fertilized, one had arrested at 10-cells and two had degenerated and were dying. Only one - an early blastocyst - was in good condition to be transferred. What a mix of emotions at that announcement! We felt sorrow for the embryos that had died, but we felt relief that we weren't going to be potentially faced with a high-risk situation. It was definitely a time to take refuge in God's sovereignty and goodness. So we transferred the one, and now we wait...
Isaiah 40:25-26 To whom then will you compare me, that I should be like him? says the Holy One. Lift up your eyes on high and see: who created these? He who brings out their host by number, calling them all by name, by the greatness of his might, and because he is strong in power not one is missing.
Trust in the Lord with all your heart, and do not lean on your own understanding. In all your ways acknowledge him, and he will make straight your paths. Be not wise in your own eyes; fear the Lord, and turn away from evil. It will be healing to your flesh and refreshment to your bones.
If I knew more about the current state of the embryos, I would probably be tempted to rely on my own understanding about what will happen tomorrow. This way, I have no choice but to lean on God. In his sovereignty and goodness, he has planned exactly what will happen tomorrow - how many blasts we'll have, how the doctor will respond if we want to transfer more than the recommendation in order to keep our convictions against destroying or freezing any form of human life. Blessing - healing and refreshment, and hopefully pregnancy - will come from obeying the Lord, not from obeying medical professionals (although we listen carefully to them). All we can do is show up for the transfer tomorrow, seek to acknowledge our Savior throughout the process, and trust that we will have a clear and straight path to walk.
I've been thinking about my willingness to do just about anything to welcome these embryos for a nice long stay. Before I go home from retrieval and transfer, the nurse hands me a sheet of post-retrieval/transfer instructions. DO NOT CONSUME ALCHOHOL! DO NOT HAVE CAFFEINE! DO NOT LIFT ANYTHING OVER 5 LBS! DO NOT HAVE INTERCOURSE! DRINK AT LEAST 48 OZ OF WATER DAILY! And I happily comply. Granted, none of these instructions ask a lot of me. But there is the allure of the forbidden. On Sunday morning, knowing that caffeine was about to be completely verboten (and even though I have already significantly cut down on my caffeine consumption), I greedily poured myself half a cup of coffee from the dregs of the pot that Aaron had made in the french press earlier. And though I am not a devotee of exercise, suddenly I have such a strong urge to lift weights. Still, I will rigorously follow the instructions given, because WHAT IF I HAVE ONE SIP OF RIESLING AND THEREBY KILL ANY CHANCES OF THIS IVF WORKING?!! I am an IVF legalist. So, knowing the vested interest that patients have, wouldn't it be great if the clinics sent home more thorough instructions? GET TO BED ON TIME! DON'T HAVE DESSERT EVERY NIGHT! READ ONLY EDIFYING BOOKS! DON'T PROCRASTINATE! ENCOURAGE OTHERS! I'd be so motivated to do all these good things, if I thought they would help me to have a baby. The very tangible and desired end of pregnancy and parenthood makes me willing, even eager, to follow the clinic's instructions. So why is it so hard to obey the instruction of the Lord? Because I often don't have a clear view of the end goal. I set my eyes on my temporal desire (like sleeping 20 more minutes instead of getting up to read my Bible) instead of gazing on the blessings to be found in obedience. I don't want to be a legalist who thinks that obedience to God's word can earn my salvation (just like I don't want to fall into the trap of thinking that my actions could prevent God from sovereignly bestowing life through this IVF), but I do want to see Christ more vividly so that I am eager to pursue Christ-likeness.
Philippians 3:13-14 "...one thing I do: forgetting what lies behind and straining forward to what lies ahead, I press on toward the goal for the prize of the upward call of God in Christ Jesus."
Stop #1: The Chicago office of our fertility clinic
We didn't even bother trying to get blood from the right arm, and the veins in the left arm - though bruised - produced admirably. The ultrasound showed about eight follicles on my left ovary, and about eleventy bazillion on my right. Maybe my right arm doesn't have any blood to spare because it's all going to that ovary? Anyway, there are 33 total follicles, 25 that are large enough to measure, and 6 that are over 20mm. Every nurse and tech that I saw built the suspense by saying things like, "Oooh, it'll be interesting to see if they trigger you today or tomorrow," "I wonder what your doctor will say," and "Looks like we need a Plan A (trigger today) and a Plan B (stim one more day and trigger tomorrow)." Clearly, I was in reproductive limbo land this morning. So we left the clinic with cell phones on, waiting to receive a call with further instructions.
Stop #2: Julius Meinl
This little Viennese cafe has become our favorite spot downtown (in Wrigleyville). They have delicious coffee, and extensive tea selection, beautiful pastries, and a tasty European-style menu. Today I had vanilla bourbon tea and baked eggs with prosciutto, spinach, mushrooms, and feta. Yum!
Stop #3: The Art Institute
We always enjoy a visit to the Art Institute, but it's rare that we have the time for it. The extensive Impressionist exhibit is probably our favorite, but today we were determined to scout out parts of the museum that we haven't seen or haven't spent much time in. I really enjoyed the current photography exhibit. One whimsical photo especially struck my fancy: a little girl with dress-up fairy wings stood back-lit in a doorway, towering over a small village of toy castles and a carpet of plastic horses, while one brother slept in a bed on the left edge of the frame and another brother eyed the toy ponies suspiciously from under a bed on the right edge of the frame. After the photography hall, we went to the wing of ancient Greek, Roman, Etruscan, and Egyptian art, and there we satisfied Aaron's archaeological inclinations. Next we headed through the American art, and we finished up with a special exhibit on Jeff Wall. Our heads full, our imaginations inspired, and our feet sore, we headed back outside. (Oh, and my cell phone rang while we were in the American art hall, with the nurse calling to say that we're going with Plan A - trigger tonight and egg retrieval on Monday!)
Stop #4: Millennium Park
We wandered through to the Lurie Gardens and sat down by the footbridge to dip our toes in the shallow waters. Very pleasant and restful, to sit on the wooden planks with cool wet feet, flowers all around, conversing with my beloved and watching small birds catch smaller bugs.
Stop #5: Pizano's Pizza
I was craving deep-dish pizza, so we had our eyes peeled for a good pizza joint as we walked toward the El. We saw Pizano's, which we had never heard of or been to, so we stopped to check out the menu. It proclaimed that its pizza was voted #1 in Chicago by Oprah and among USA Today's Top 10, so we gave it a shot. Of course, after we sat down, we realized that it was the thin crust that got rave reviews, not the deep dish. We went ahead and ordered thin crust (with pepperoni and fresh garlic), and it was pretty tasty. Their Caesar salad was also scrumptious.
Home again, home again, jiggity-jig
Appetites for ART and art (and food!) satisfied, we headed back to the suburbs. I'm so glad we could turn a pre-IVF check-up into a truly enjoyable day downtown. Now, it's time for me to take an Ovidrel shot to ripen up my follicles for an 8 a.m. egg retrieval on Monday!
I have some more thoughts I'd like to post in the next few days, but I'll stick to this little medical update for now. In sum, I'm physically tired but spiritually encouraged. I feel mostly like I'm on IVF autopilot, and hope for this cycle to work hasn't made any sort of grand entrance yet, but I still feel relatively joyful and peaceful. Hope will probably jump in around the time of egg retrieval, so I just want to get there!
Aaron and I had a mini-crisis with this IVF when we realized on Sunday night that he mistakenly scheduled a business trip for next week, when retrieval and transfer most likely will happen. My first reaction was completely sinful - although I felt completely justified at the time. I was judging Aaron, mentally accusing him of not caring enough about our infertility treatments to have a clear grasp of what will happen when and then not caring enough to offer to reschedule his travels. I quilted a cozy blanket of self-pity to wrap around my shoulders: "Woe is me, infertility has made conceiving so clinical and detached and now my husband won't even be there to hold my hand while the catheter of embryos is inserted into my uterus! He won't be there to take care of me after the procedures! What friend could drive me into the city for transfer who wouldn't offend everyone in the clinic waiting room by bringing either a child or a pregnant belly? I'll have to find someone to come administer my PIO shots every night. It will be pointless to ask people to bring meals for lonely old me. I'll just have to sit around by myself and do a jigsaw puzzle or something. Woe! Woe!" Pretty fancy how quickly I could stitch that up, huh? Of course, I said none of this to Aaron, so he had no idea. Meanwhile, he was thinking about how special it was to witness the embryo transfer together last time, and he intended to ask a colleague to swap travel plans with him. Which he did. And the colleague was more than happy to trade. So Aaron is currently in New Orleans, and he won't be going to Louisville next week, and we talked it all out, and I confessed, and he forgave me, and he'll hold my hand during transfer next week, and my very own husband will give me injections in my rear, and everything is hunky-dory. Lessons learned - don't sinfully judge your husband, and don't make a marriage (lovely as it may be) into an idol to replace the idol of having a baby. Yes, having several unexpected years just the two of us has helped to make our marriage stronger and closer, but a wonderful marriage is not a compensation package that I am entitled to because I don't have children, and a perfect marriage is not a way to tip the cosmic scales and earn success at IVF, and a fulfilling marriage will still never satisfy the way only God can.
For this IVF, Dr. Peppy gave us the option of telling the lab we want to do a day-5 transfer. I feel torn about this option. On one hand, we risk having nothing to transfer if none of the embryos survive until day 5. But, if one or two did make it to day 5, then we would have a better chance of success with a blastocyst transfer. I'm inclined to be conservative and stick with the day-3 transfer. Any opinions out there?
I start Follistim tonight. I'll be on a slightly lower dose than the last IVF (175 IU rather than 200). I have to go into the city on Sunday for an ultrasound and bloodwork, and I'm hoping that I can get an early appointment so I don't end up missing church three Sundays in a row!
*One new element in the protocol will be estrogen patches starting 6 days after retrieval, to support the uterine lining. It's a new standard at my clinic. Has anyone else done this?
For several miles, we defied the laws of physics and geography by travelling north and south at the same time! Okay, maybe we were really heading east-ish, but for a stretch in Virginia (I think) we were on I-77S and I-81N simultaneously. (Reverse all that for the return trip.)
Also, we discovered that there are Tim Horton's in Ohio. Probably only the Pronovosts will understand the magnitude of that news...
The WalMart of Southport, NC, came fully stocked with sharps containers, available for the low, low price of $1.29.
One nephew (age 3) frequently ended his sentences with the word "baby." For instance, "Let's play Thomas the train, baby!" Or, "My shorts are on backwards, baby!" Highly amusing.
On our return trip, we stopped in WV for a family reunion at Aaron's parents' house. Even though the event was full of young Mormon families (read 23-year-olds with 4 children), not once did I get asked the dreaded, "So when are you guys going to have kids?" What a success!
I hope to post some pictures later this week. It was great to get away and relax, and now it's great to be back home.